Arshad Mahmood, Tariq Ghafoor, Shahida Badsha.
Wilms Tumor: presentation and treatment.
J Coll Physicians Surg Pak Jan ;14(3):142-5.

Objective: To determine the clinical presentation and treatment results of patients of Wilms tumour treated with United Kingdom Children`s Cancer Study Group (UKCCSG) protocol. Design: An interventional study. Place and Duration of Study: The study was conducted in the Paediatric Oncology Department of Combined Military Hospital, Rawalpindi (CMH RWP), from January 1999 to December 2000. Subject and Methods: All patients of Wilms` tumour managed by using UKCCSG treatment protocol were included in the study. The patients were thoroughly investigated before treatment. Surgery, chemotherapy and radiotherapy were performed as per protocol. Results: Twenty-two patients including 13 boys and 09 girls with the mean age of 28 months, ranging from 4 months to 7 years were studied. The tumour involved right kidney in 13 and left in 9 patients. Two (09%) patients had stage I, 5 (23%) stage II, 11 (50%) stage III and 04 (18%) stage IV disease. Histology was favourable in 18 and unfavourable in 04 patients. Nineteen (86.4%) patients underwent primary surgery, one had delayed surgery while 02 (9%) patients had inoperable tumour and died despite chemotherapy. Three patients died during maintenance chemotherapy and one after completion of treatment. The overall mortality was 06 (27.3%). Three patients were lost to follow-up. Conclusion: The treatment outcome is comparable to UKCCSG results. Challenges to be addressed in our set up include illiteracy, deficiency of resources, and regularity of treatment and follow-up. system and, therefore, its application is recommended to evaluate ovarian masses in clinical practice.

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